Peri-implantitis is a major cause of
dental implant failure. Bacterial biofilm contamination on the implant induces surrounding
bone resorption and soft tissue
inflammation, leading to severe deterioration of oral health. However, conventional biofilm removal procedures, such as mechanical decontamination and
antiseptic application, are not effective enough to induce reosseointegration on decontaminated implant surfaces. This is due to (1) incomplete decontamination of the biofilm from inaccessible areas and (2) physicochemical alteration of implant surfaces caused by decontamination procedures. Herein, a safe and effective therapeutic approach for
peri-implantitis is developed, which involves decontamination of implant-bound biofilms using the kinetic energy of microsized
oxygen bubbles generated from the catalytic reaction between
hydrogen peroxide (H2O2) and
manganese oxide (MnO2) nanozyme sheet-doped
silica diatom microparticles (Diatom Microbubbler, DM). Rapidly moving microsized DM particles are able to penetrate narrow spaces between implant screws, exerting just the right amount of force to entirely destroy biofilms without harming the surrounding mucosa or implant surfaces, as opposed to conventional
antiseptics such as
chlorhexidine or 3% H2O2 when used alone. Consequently, decontamination with DM facilitates successful reosseointegration on the
peri-implantitis-affected implant surface. In summary, our new DM-based therapeutic approach will become a promising alternative to resolve clinically challenging aspects of
peri-implantitis.